Fig. 2. (4×Magnification) Hematoxylin-eosin staining showing
features suggestive of lobular capillary hemangioma.
The patient was then referred to the Department of Oral Surgery for
further management where the whole lesion was excised and sent for
biopsy. The second biopsy report was also suggestive of lobulated
capillary hemangioma.
DISCUSSION
Haemangiomas constitute about 7% of all benign tumors in infancy and
childhood9. An increase in the number of normal or
abnormal vessels engorged with blood is characteristic of these
entities. These lesions are broadly identified as (a) cavernous and (b)
capillary haemangioma. Cavernous haemangiomas are composed of large
dilated vascular channels that can infiltrate and involve deeper
structures making spontaneous regression a rare possibility. Capillary
haemangiomas are more common in comparison to cavernous type. These
occur in the skin, subcutaneous tissues, and mucous membranes of the
oral cavity, lips as well as in the liver, spleen, and
kidneys9.
Lobular capillary haemangiomas are a benign proliferation of capillaries
that usually arise on the face, lips, or hands after episodes of minor
trauma10.
They do not show age preponderance but are more common in children and
young adults, especially in men. It displays various clinical features
suggestive of reactive neovascularisation. It has a limited capacity to
grow, with a propensity for multiple eruptions that may be localized or
disseminated.
Lobular capillary haemangioma remains an etiopathological enigma.
Trauma, inflammatory and infectious agents are the suspected causative
factors. It is a relatively common benign mucocutaneous lesion occurring
intraorally or extra orally. It is a common lesion that presents with
varying clinical features that may sometimes mimic more serious lesions
such as malignancies.
Lobulated capillary haemangioma may resemble a squamous cell carcinoma
because it usually has an ulcerated patch on its surface. It is softer
on palpation and bleeds easily, and usually, its instigating irritant
can be found11.
In a review of 639 vascular lesions of the oral cavity and upper
respiratory tract 73 cases presented with characteristic features of
Lobulated capillary haemangioma. Among the various sites, the lip was
the most common site involved (38%). LCH presents as a spontaneous,
painless, bleeding mass. There is a predilection for males less than 18
years old, females in the reproductive years, and an equal sex
distribution beyond 40 years of age12.
As an adage says, ‘Eyes cannot see what the mind does not know’, a
clinician, not cognisant of the possibility of this lesion in its
unusual site mistakes it for the more serious ones and might jump to
conclusions which often leads to misleading results, uncertainty, and
mistrust. This is easily overcome by histopathology which confirms its
innocuous nature.
CONSENT STATEMENT: Written informed consent was obtained from the
patient’s guardian as per guidelines to publish this report.
FUNDING: None
ACKNOWLEDGEMENT: None
CONFLICTS OF INTEREST: The authors have declared no conflict of
interest.
ETHICS STATEMENT: None
DETAILED AUTHOR’S CONTRIBUTION:
1. Rajlaxmi Mitra
Writing-Original draft
2. Akhilanand Chaurasia
Writing-Review and Editing
3. Ranjit Kumar Patil
Supervision and validation
DATA AVAILABILITY STATEMENT: None
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